Moving into Balance
  • Welcome
  • Finding Balance
    • Boom & Bust
    • Activity Diary
    • The 4 Ps
    • Pacing Your Energy
  • Moving Well
    • Inactivity
    • Exercise
    • How to Begin
    • Posture
    • How to Progress
  • Breathe & Unwind
    • The Physiology of Stress
    • Breathing Well – Feeling Steady
    • Tools to Help
  • Finding Rhythm
    • The Body Clock
    • The Effect of Light
    • Resetting the Clock
  • Mindfulness
    • Mindfulness Websites
    • Mindfulness Websites
    • Mindfulness CDs and Audio
  • Yoga
    • Yoga
    • Helpful Books
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Pacing Your Energy

 ADAPTIVE PACING TECHNIQUE
 

Put simply, pacing is knowing how long you can spend in a particular activity, and stopping when you have reached that point.

Sounds easy, but is very hard!

Pacing is difficult because it brings us face to face with our limitations. Often our mind wants to push our body beyond its current capacity. We get into the flow of an activity and don’t WANT to stop.

However , through experience and carefully noticing our responses to particular activities, we become aware of what we can manage. This is true for activities that we enjoy, as much as for activities that feel more like work.

The principle of pacing is to identify the physical positions or the tasks which consistently tend to flare-up your symptoms, or create tension and difficulty for you.  Common examples of activities people find they need to pace would be; Walking, computer work , ironing, cooking, driving, as well as fun things like artwork, sewing or knitting !
The guidance is to record the amount of time you can spend in the activity before you begin to notice any adverse effects.  Then you need to calculate 8o % of that maximum time. This is known as your baseline. The discipline is to only spend this amount of baseline time on the challenging activity!  For example, if you know that you can work at the computer for 3o minutes before your back pain begins to trouble you, then
​
3o divided by 1oo and x 8o= 24 minutes

24 minutes is the longest time you can spend on the computer if you want to avoid flaring up your back pain.

At first this looks very tedious. However, if you do flare up your pain, you may need to stop, perhaps take more pain-killers and maybe even give up the job for the rest of the day! If you are disciplined, maybe even setting a timer, you can STOP, rest for a short spell, and then return to your work for another 24 minutes .You will actually achieve more!

This method is beautifully described by Vidyamala Birch., the author of ‘Living Well with Chronic Pain and Illness’. She has also written a little pamphlet on pacing called ‘The mindfulness of daily life’.

Vidyamala lives with chronic pain after a spinal injury over 3o years ago. She has led a full and successful life, and uses pacing or ‘mindful rhythm’ to manage her difficult symptoms. In fact she has written several books in 2o minute chunks.

You can find out more about her work on:-
http://breathworks-mindfulness.org.uk/

Obviously some tasks are not easy to stop once you have started.  If you are working the pace you are require to work at may be outside your control. Doing a big supermarket shop, or driving long distances can be difficult to interrupt. But, as best as possible, become aware of your baselines and do your best to adapt your activities to respect the, finding creative ways to take a break.
Using the ‘Breathing Space’ , ‘Heartmath’ or even just scanning for and releasing tension can help when you are not free to stop.
Ultimately, when you are comfortable with your ability to pace, you may be able to raise your baselines. This will depend on the nature of your health difficulty. If you are keen to try, it is important to increase by no more than 2o % at a time, and only when you are sure that you are feeling well.

SOME CASE HISTORIES

Pacing is not easy. Here are a few example of how to apply the principles in a way that might help you see how to work within your own circumstances.

MARY, is 57 and has Fibromyalgia.


When filling in the activity diary Mary noticed that during the week she rarely goes out, except to the local shop for odds and ends. She looks after her 3 year old grandson after playgroup on Tuesdays from 12 – 5 pm.  Generally she tries to get all her jobs done in the morning, and sleeps for a variable time most afternoons, making dinner for her husbands return from work.  Then they watch TV for most of the evening. On Saturday morning Mary and her husband do the shopping for the week in the local supermarket.  Then she goes into town with her sister, and they go around the shops and for a coffee. She tends to be in bed for most of Sunday morning.

​She struggles with fatigue and aching muscles-the pain is predominantly around her neck and shoulders but is variable from day to day. Her sleep is broken and unrefreshing.

What could Mary try?

Mary tends to be most active in the morning. She sleeps most but not every afternoon for a variable length of time , and has a major burst of activity on Tuesday afternoon and all day Saturday. She tends to crash on Sundays.
  1. Mary Booms in the morning and Busts in the afternoons. It would be better if Mary could spread her jobs out during the day, taking short breaks for a cup of tea or to relax and release any build up up tension around her neck and shoulders.
  2. Having a short nap every day at a set time, would be a good way of building a routine. She could then be rested enough to get through the rest of the day. She could begin to use an alarm, and notice the minimum amount of sleep she needs to be refreshed enough to be up and about. This will help to reset her body clock , and may help her sleep better at night. She will also be inactive for the least time necessary, reducing any further weakness of her postural muscles and circulatory system. On Tuesdays this rest time is not possible , so doing fewer jobs in the morning and spending 2o minutes or so practicing a relaxation technique, may help her enjoy the afternoon with her grandson without become totally exhausted.
  3. It might be possible to do the supermarket shop in an evening, or on Sunday, rather than trying to do so much on a Saturday. At present the weekends show a total Boom and Bust pattern, with the inevitable crash on Sunday!
  4. Mary’s routine shows long spells of inactivity. Her fitness level is fairly low. We will look at ways of building physical stamina in the ‘Moving Well’ section, but it would be helpful to Mary’s body to break up the evening with some activity. Perhaps she and her husband could begin a little walking programme, starting with very short walks and gradually increasing at Marys pace-not her husbands! Perhaps she could use the exercise guidance here to begin to use her stairs to build stamina, or begin some of the helpful stretches for her neck and shoulders. It would definitely be important to explore ways of dropping little spells of gentle exercise into her daily routine. This would help her sleep and may eventually help her mood as well! Gradually building up her exercise level will ultimately improve her stamina throughout the rest of the week.
  5. Mary really enjoys her shopping trips, and is reluctant to give them up although they are becoming increasingly difficult. Hopefully as she reduces her inactivity throughout the week and with careful exercise she begins to become a little stronger, these trips will become less draining.
  6. At the moment, it is important that she takes regular breaks, to allow her body to re-stabilise. She will need to negotiate the coffee stops with he sister! Of course it might also be an idea not to drink too much coffee if she wants a good nights sleep!

ELIZABETH-is 46 struggles with chronic fatigue and works part-time.

Elizabeth works on Tuesday Wednesday and Friday. She knows that she tends to crash on Wednesdays and at the weekends, hoping that if she rests she will have enough energy to get through her work days. She does her household jobs on Mondays, and throughout the weekend, but never feels on top of anything. She realises that she uses coffee and sugary snacks to keep herself going.

What could Elizabeth try?
  1. If we took the pacing theory to its logical conclusion, it would be best for Elizabeth to spread her working hours throughout the week. However, this is not possible, both from the point of view of her employers, and because she travels to work on public transport and it would be too expensive to travel every day. Elizabeth needs to build in short regular wind down time throughout her working day, noticing when she is becoming stressed and fatigued, and allowing her body to release as much held tension as possible. Holding tension is very physically tiring, and also sends negative messages to thought and emotional centres.
  2.  It would be helpful if Elizabeth could find ways to build some physical exercise into her working day, taking regular breaks to walk a specified length of corridor, or do some stair exercise. Doing this 3 to 4 times during the day and gradually increasing the distance or number of stairs as a simple exercise or ‘rehab’ programme. Her work colleagues may be a bit amused by this, but, that’s their business! Elizabeth’s business is to maximise her well-being and health.
  3. Elizabeth could introduce some time for a gentle exercise plan on her days off, gradually building more strength and endurance. This isn't easy but really is possible with skill, patience and persistence.
  4. Elizabeth should begin to notice how she tries to manipulate her physiology with caffeine and sugar. This can have a depleting effect on our body chemistry. Using sugary snacks can be particularly harmful. See the section on nutrition / syndrome 

GORDON- is 52 and has high blood pressure.
He struggles with Stress and Fatigue.


Gordon works full time. He comes home form work and needs to sleep for an hour before he can get up and have something to eat. He works as a financial advisor in a busy office, and rarely stops for lunch. He feels as if he is on a hamster-wheel, stressed and exhausted most of the time.

What could Gordon try?
  1. Since Gordon struggles with High blood pressure, it is really important that he takes stock of his life goals. This is a really difficult situation; he has a mortgage to pay and a family to support. Yet, if he gets more unwell, he will not be able to continue with these responsibilities. A simplistic answer based on the principles of pacing, will not give Gordon the answers and support he needs- although he does need to review the pressure and stresses he feels at which he works. Finding ways to build in regular ‘unwinding’ breaks at work needs to be explored, perhaps using the ‘breathing space’ or ‘heartmath’ to allow his physical systems to re-stabilise. Making sure he gets home on time, and finding space for things he enjoys is also very important.
  2. Finding ways to introduce enjoyable physical exercise will be very important for Gordon. To maintain good cardiac health it is advisable to exercise for at least 3o minutes each week, increasing your heart rate to around 7o % of its maximum capacity. This is discussed in the Moving Well section.
  3. However, the biggest challenge for Gordon is to reconnect with his own needs and self –care. This often involves a significant shift in self awareness and attitude, noticing internal values and perspectives. Sometimes mindfulness practices can be helpful in identifying the thoughts and attitudes which keep us pushing ourselves-sometimes to prove our worth to ourselves or others. A huge topic, and beyond what we can look at here.

JENNIFER, is 32 and is recovering from glandular fever.


Jennifer is very keen to rebuild her previous fitness. She is struggling with her return to work as a primary school teacher, and tends to catch any bug that is going around the school. She goes to the gym on Wednesdays after work with her friend, and goes to an aerobics class, followed by a swim for about 3o minutes. She is exhausted afterwards and finds Thursday a challenge, occasionally having to take the day off.

What could Jennifer try?

  1. Jennifer tends to Boom and Bust with her exercise plan. She is reluctant to give up her trips to the gym, but may need to manage her visits differently.
  2. Exercising in a class is great fun, but introduces competition and an expectation of being able to keep up with everyone else. Jennifer’s immune system has been compromised temporarily by a virus from which she is recovering. Exercise is certainly useful, since often people become fearful and lose confidence in their body’s ability to heal and recover.  However this needs to be done at her own pace. It might be sensible to stay at the back of the class, letting the teacher know that she will work at her own level, being aware of her body’s needs. Often when recovering from an illness, or working with a health issue, gentle Hatha style Yoga is a useful method of regaining strength. Jennifer could explore whether there is a class of this type available. If well taught, Yoga can develop body awareness and confidence as well as stamina and healthy breathing.
  3.  It might be better to go swimming on a different night if that is practically possible-rather than to fit so much exercise into one session.
  4. Filtering some exercise into the rest of the week would be a good idea-a walk at lunchtime, or in the evening, gentle jogging or whatever Jennifer would enjoy. Doing something you find fun and enjoyable is really important, and will further enhance the positive benefits of the exercise!
Next: Pacing your Energy

Using an activity diary

Many people find it helpful to create an activity diary. here's a sample activity diary,
Microsoft Word Document
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  • Welcome
  • Finding Balance
    • Boom & Bust
    • Activity Diary
    • The 4 Ps
    • Pacing Your Energy
  • Moving Well
    • Inactivity
    • Exercise
    • How to Begin
    • Posture
    • How to Progress
  • Breathe & Unwind
    • The Physiology of Stress
    • Breathing Well – Feeling Steady
    • Tools to Help
  • Finding Rhythm
    • The Body Clock
    • The Effect of Light
    • Resetting the Clock
  • Mindfulness
    • Mindfulness Websites
    • Mindfulness Websites
    • Mindfulness CDs and Audio
  • Yoga
    • Yoga
    • Helpful Books